Ah, the humble herb. Simultaneously a relic of a bygone medical era, and one of the cutting edges of pharmaceutical research today.
The term “herb” doesn’t have a very rigid definition. For our purposes here, I’m just going to define it as “any plant used for medicinal purposes;” as you may remember from last week’s discussion of elemental imbalances and how they’re treated, that means a whole lot of not just culinary herbs but also spices, fungi, and even mundane vegetables. Basically, if it’s organic and doesn’t move around on its own, it might fit into the scope of this essay.
Let’s start with the “bygone medical era” part. Herbal medicine is beyond ancient: since eating some things (food) makes you feel good, and eating other things (poison) makes you feel bad, and eating still other things (hallucinogenic plants) makes you feel weird, then when you’re sick, it’s logical that eating the right things might help.
But how do you figure out what will help? Some of it was trial and error: whoops, Glub the Caveman died after eating those mushrooms, so probably best not to try that one again. Iterated over thousands of years, you learn some useful things, like the fact that willow bark can ease pain and reduce fever. South Americans used cinchona bark for the same purpose, and then it became vastly more important when Europeans showed up and brought malaria with them, because people rapidly discovered it had the capacity (thanks to its quinine content) to treat the disease.
That’s the slow way of figuring things out. A faster way — but unfortunately an erroneous one — is to rely on the doctrine of signatures: the idea that God provided a visual key to the proper use of herbs by making them resemble the things they were meant to treat. For example, the paired tubers of some orchids look like testicles, so maybe they were good for curing testicular problems. (“Orchid” is from the Greek word for “testicle.” Think of that the next time you see one!) The spots on the leaves of the Pulmonaria genus resembled the appearance of diseased lungs, so it became known as “lungwort” and was used to treat pulmonary infections. The flowers of birthwort looked like the birth canal, ergo the plant must be good for assisting in delivery.
Spoiler: this doesn’t work at all. In a fantasy setting it could, but in the real world birthwort is more likely to give you renal failure than do you any good.
Ideas like the doctrine of signatures, or the elemental philosophies that assigned herbs to particular categories based on their external characteristics and then expected them to have the effect the framework said they should, are responsible for much of herbalism’s bad reputation. But it isn’t all nonsense; I’ve already mentioned willow bark and cinchona, and those are far from the only plants that have turned out to carry real benefit for treating illness. Pharmaceutical companies these days are spending vast amounts of money researching the traditional medicine of indigenous groups in the hopes of finding new chemical avenues to pursue. One of the many reasons we should be worried about climate change is that the extinction of plant species may rob us of new medical treatments that could save lives.
The thing about herbal medicine, though, is that it’s complicated. I don’t mean that its preparation is more complex than the chemical synthesis that goes on in laboratories — though it can indeed be complicated in its own way, as with the Anglo-Saxon eye salve tested a few years ago, which turned out to cut through a petri dish of bacteria like a knife through butter. No one is yet sure which components of its recipe can safely be eliminated without reducing its efficacy. But even when there’s only one plant involved, there are a lot of chemicals in it, whereas a factory-produced pill usually only has one or two active ingredients.
Sometimes this is a good thing, because it turns out those chemicals work together well, becoming more efficacious or countering each other’s side effects. Sometimes . . . not so much. And what about dosage? How much quinine is in a six-inch strip of cinchona bark, and can you be sure that it’s the same as this other six-inch strip I got from a different tree? It’s much more of a guessing game. Which means that herbal medicine has all the unpredictability of modern pharmaceuticals — the variable factors of age, weight, sex, personal biochemistry, and so forth — plus more besides.
But it’s a mistake to think of herbalism purely from the standpoint of modern scientific thought. It’s bound up in a whole cosmology and worldview, like those elemental systems I mentioned before. There may be a ritual component to the gathering or preparation of the medicine; it’s common in shamanic or tribal societies to say a prayer before cutting or plucking or uprooting the plant, asking its spirit to help cure the sick. Instructions for creating a tincture or salve might include the words to recite over it while it boils, or the right time of day or season of the year to coax efficacy out of the material. In some cases you can see a possible scientific effect — the chemical content might very well fluctuate with the seasons — but not all of this is reducible to rational explanations.
Which is one of the reasons indigenous groups aren’t always thrilled about outside researchers tromping around looking for samples of the herbs they use. That approach pays zero attention to the context; it’s only interested in extracting the chemical. There’s no respect for the local culture beyond how it can be monetized (and usually monetized only for the benefit of the corporation, not the people whose traditions helped lead to that breakthrough).
And don’t lose sight of the placebo effect. We tend to talk about that as if it’s imaginary and unimportant, but there’s an increasing pile of research that shows placebos can have a beneficial result, even if you tell the patient they’re taking a placebo. Anti-depressants work better if the pill is a bright color, but anti-anxiety medication is more effective if it’s a nice soothing shade of blue. So does herbalism work better when it’s accompanied by prayers and supported by a philosophical framework that connects it to the rest of your life? That’s not going to overcome everything — belief won’t prevent renal failure — but in some cases it may indeed make a difference.